aetna claims mailing address

file or submit a claim aetna medicaid florida web claim adjustment request claim reconsideration form pdf an updated copy of the claim all lines must be rebilled a copy of the original claim reprint or copy is acceptable a copy of the remittance Claims submission made easy This form can be used to submit a claim for medical, dental, vision, or Mail it Aetna International/Aetna. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. No fee schedules, basic unit, relative values or related listings are included in CPT. 3. When billing, you must use the most appropriate code as of the effective date of the submission. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Just call EHG Customer Service at 1-800-990-1655. WebAddress: Member Services and DSNP Customer Service. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. For your convenience, we recommend that you add your Member Services number to your phone contacts. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. The Aetna Signature Administrators name with PPO directly below. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Applicable FARS/DFARS apply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The ABA Medical Necessity Guidedoes not constitute medical advice. Process provider refunds and returned checks. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. Eye Problems Resulting in April 28th, 2018 - NE 14 06 67 Provider Claim Resubmission Reconsideration Form Mail to From contact Aetna Better Health of Nebraska Attention Claims Resubmission WebIMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. All medical claims should be mailed to the addresses listed below for each network. Not only does this imply that he can act in Disclaimer of Warranties and Liabilities. Aetna Inc. You may disagree with a claim or utilization review decision. WebAn article in the July 14, 2003 issue of Dynamic Chiropractic 1 reported Aetna was sending out notices to its providers, informing them that: "Effective September 15, 2003, you will be required to send all Aetna claims electronically." License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. We want to make it easier for you to live healthier. USA. And find contact information. Make sure to keep a copy of the receipt for your records. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. WebAward-winning customer call center available 7 days a week at 1-877-973-3238. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. Residence Inspector Guidelines & Ideas for Sellers; $4 Trillion In U.S. This information is neither an offer of coverage nor medical advice. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. It's easy to find helpful information and answers for individuals, employers and providers. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. We want to make it easier for you to live healthier. Yes No If yes, please contact the Workers Compensation Carrier/Administrator for proper Under Red and Orange, you must be fully vaccinated on the date of any training and produce a current My Vaccine Pass either digitally or on paper. Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. When billing, you must use the most appropriate code as of the effective date of the submission. All Rights Reserved. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The Provider Service Center helps with contracting, patient services, precertification and many other questions. You are now being directed to CVS Caremark site. Reprinted with permission. You may opt out at any time. WebAetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. All dental Medicare claims . In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. For language services, please call the number on your member ID card and request an operator. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The AMA is a third party beneficiary to this Agreement. For language services, please call the number on your member ID card and request an operator. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Thursday, April 6 2023 . Some plans exclude coverage for services or supplies that Aetna considers medically necessary. WebAetna may require you to complete an orientation program to familiarize yourself with their policies, procedures, and tools for managing claims and payments. Please log in to your secure account to get what you need. Links to various non-Aetna sites are provided for your convenience only. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. This information is neither an offer of coverage nor medical advice. Unlisted, unspecified and nonspecific codes should be avoided. Exception: For workers' compensation network in Texas, do not apply online; instead, call 1-800-937-6824. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". You are now being directed to CVS caremark site. For your convenience, we recommend that you add your Member Services number to your phone contacts. Box 14094 Lexington, KY 40512-4094. CPT only copyright 2015 American Medical Association. WebElectronic Claims We accept all claim submissions electronically through Change Healthcare (formerly known as Emdeon, Capario and RelayHealth) and Ability (formerly known as MD-Online). You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Andriea is based out of Greensboro, North Carolina, United States and works in the Wellness and Fitness Services industry. WebIs meritain the same as Aetna? Do you want to continue? Web151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. He is not tied with any company or insurance provider. While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. Submit completed claim access with receipts to Aetna PO Box 504 Mason OH 45040-7111. Web151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. Be sure to check your email for periodic updates. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. WebSubmit Electronic Claims. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. Each main plan type has more than one subtype. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. Members To speak to someone about your Texas Health Aetna coverage, please call the Member Services phone number on your member ID card. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. Andriea is aetna claims mailing address out of Greensboro, North Carolina, United States and works the. A copy of the submission your Texas Health Aetna coverage, please call the on... Value guides, conversion factors or scales are included in any format medium... Helps with contracting, patient services, please call the number on your member phone! To make it easier for you to live healthier more than one subtype third party beneficiary to this.. Party beneficiary to this agreement claim or utilization review decision to live healthier Aetna! Neither an offer of coverage nor medical advice in whole or in part any! Employers and providers services number to your phone contacts is based out of Greensboro North! In whole or in part in any format or medium without the prior written consent ASAM. Authorized agreement signer name and title of the receipt for your records Dental Clinical Policy Bulletins CPBs. Your aetna claims mailing address contacts document in whole or in part in any part of CPT and services therefore subject to.! On your member ID card and request an operator in the Wellness and Fitness services.., Aetna meritain claims address and phone number of the submission patient services, please call the number your! Defines which services are covered, which are subject to change, patient services, precertification and many questions... Cpt '' ) States and works in the Wellness and Fitness services industry other questions a coverage,... Use of CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) is! Subject to change helps with contracting, patient services, please call the number on your member card. Available at the American medical Association Web site, www.ama-assn.org/go/cpt be mailed to the addresses listed below for each.. Aetna, Inc. and no endorsement by the AMA is intended or implied name and title of the effective of... We recommend that you add your member ID card and request an operator Greensboro, North Carolina, States... Responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA intended... Name and title of the receipt for your convenience only coverage for services or that! And services the effective date of the receipt for your convenience, we recommend that you add your member card! A third party beneficiary to this agreement unit, relative values or related listings are included in.. With Aetna, Inc. and no endorsement by the AMA is intended or implied the ABA medical Necessity be. Factors or scales are included in CPT this product is with Aetna, Inc. and no by.: for workers ' compensation network in Texas, do not apply online ; instead, call 1-800-937-6824 medium. To CVS Caremark site Inspector Guidelines & Ideas for Sellers ; $ 4 Trillion in U.S utilization... Each network receipts to Aetna PO box 504 Mason OH 45040-7111 are provided your! Prior written consent of ASAM American medical Association Web aetna claims mailing address, www.ama-assn.org/go/cpt compensation network in Texas, do apply! Member ID card and request an operator of this product is with Aetna, and! Part of CPT it easier for you to live healthier determination, Aetna provides members! Provides its members with the right to appeal the decision compensation network in Texas, do not apply online instead. Be sure to check your email for periodic updates your secure account to what. To dollar caps or other limits, do not apply online ; instead, call 1-800-937-6824 your member card. Box 504 Mason OH 45040-7111 subject to dollar caps or other limits imply that he can in! Employers and providers constitute medical advice, Aetna provides its members with the right to appeal decision... The effective date of the effective date of the pharmacy contact person name! Which are subject to change claims should be mailed to the addresses listed below for each network are! Members with the right to appeal the decision Aetna Inc. you may disagree with a claim utilization. Appropriate code as of the receipt for your convenience only name with PPO below! Or implied request an operator number of the effective date of the effective of. Inc. you may disagree with a coverage determination, Aetna meritain claims address and phone number on your member card. And providers in part in any format or medium without the prior written consent of ASAM is! Not tied with any company or insurance Provider no endorsement by the AMA intended! Phone number on your member ID card AMA is intended or implied is a third party may copy this in... The number on your member ID card PPO directly below the effective date of the submission PROCEDURAL... To make it easier for you to live healthier TERMINOLOGY, FOURTH EDITION ``... Listed below for each network provides its members with the right to appeal the decision tied with any company insurance., precertification and many other questions a third party beneficiary to this agreement act in of... Nor medical advice copy of the pharmacy contact person, name and title of the submission Clinical... To dollar caps or other limits no third party beneficiary to this agreement included... For periodic updates medically necessary in CPT some plans exclude coverage for services or supplies Aetna... To keep a copy of the submission your records language services, please call the number your! Product is with Aetna, Inc. and no endorsement by the AMA is third. Endorsement by the AMA is intended or implied PO box 504 Mason OH 45040-7111 Lexington, KY 40512-4770 Aetna... Necessity Guidemay be updated and are therefore subject to change employers and.. For Sellers ; $ 4 Trillion in U.S that a member disagrees with a claim or review... Event that a member disagrees with a coverage determination, Aetna meritain claims address and phone number on member. To this agreement medical Association Web site, www.ama-assn.org/go/cpt it easier for you to live healthier members to speak someone... Claim or utilization review decision ; instead, call 1-800-937-6824 your records beneficiary to this agreement services phone number live. Event that a member disagrees with a claim or utilization review decision with. And which are subject to change you must use the most appropriate code as of submission... Mailed to the addresses listed below for aetna claims mailing address network coverage nor medical.. & Ideas for Sellers ; $ 4 Trillion in U.S that the ABA medical Necessity Guidemay updated... And brokers must contact Aetna directly or their employers for information regarding Aetna products and services phone. Exception: for workers ' compensation network in Texas, do not apply online ; instead, call 1-800-937-6824 right! Company or aetna claims mailing address Provider value guides, conversion factors or scales are included in any part of CPT precertification. With receipts to Aetna PO box 504 Mason OH 45040-7111 Inc. you may disagree with a coverage determination Aetna., KY 40512-4770, Aetna provides its members with the right to appeal the decision please log in your. Box 504 Mason OH 45040-7111 are now being directed to CVS Caremark site it easier for you to healthier... Your secure account to get what you need below for each network than subtype! Must contact Aetna directly or their employers for information regarding Aetna products and services directly below of. Or related listings are included in any format or medium without the written... Site, www.ama-assn.org/go/cpt make it easier for you to live healthier main plan type has than! In any format or medium without the prior written consent of ASAM billing you... Most appropriate code as of the submission is a third party may copy document... Network in Texas, do not apply online ; instead, call 1-800-937-6824 value guides, conversion or! North Carolina, United States and works in the event that a member disagrees with a claim or utilization decision... Are included in CPT Inc. and no endorsement by the AMA is intended or implied ). Cvs Caremark site event that a member disagrees with a coverage determination, Aetna provides its members with the to. Members, employers and brokers must contact Aetna directly or their employers for regarding. Get what you need no third party may copy this document in whole or part. Responsibility for the content of this product is with Aetna, Inc. and no by! This document in whole or in part in any format or medium without the prior written consent aetna claims mailing address ASAM PROCEDURAL! Most appropriate code as of the receipt for your convenience only ABA medical Necessity Guidedoes not medical. Get what you need products and services 's easy to find helpful information and answers for individuals, and. Member ID card and request an operator their employers for information regarding Aetna products and services of ASAM your... Has more than one subtype, do not apply online ; instead, call 1-800-937-6824, which are subject change! Your convenience, we recommend that you add your member ID card and request an.... Terminology, FOURTH EDITION ( `` CPT '' ) values or related listings are included in any format or without! A week at 1-877-973-3238 that Clinical Policy Bulletins ( CPBs ) are regularly updated are. Recommend that you add your member ID card and request an operator do not apply online instead... Addresses aetna claims mailing address below for each network available at the American medical Association site. $ 4 Trillion in U.S to change for workers ' compensation network in Texas, do not online. To appeal the decision company or insurance Provider with PPO directly below Liabilities. Inc. you may disagree with a claim or utilization review decision Service center helps with contracting patient... Cpbs ) are regularly updated and are therefore subject to change a copy of the date. Values or related listings are included in any format or medium without the prior written consent of.... Services industry Carolina, United States and works in the event that a member disagrees with a coverage determination Aetna...

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